02-08 Small Kitty amps 410 pmps 293 +2 245 +4 189 +5 299 - Devastating

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Morning all,

First I'd like to say thanks to Bobbie and Jill for their post yesterday. The fact that Boubba went
all the way to 5 on the ketone meter and he wasn't DKA is ''reassuring''. Thanks Jill for your rationality
in putting everything together. Even with this in mind, it's hard not to be concerned. Yesterday's
black came out of nowhere, it cannot be just any hazard. Just hope it's because of the 60cc Sub-Q
that made the system going to a kind of descale, like coffee machine you're cleaning up.

Talking about coffee it's time for it, Sub-Q injection takes time and don't want to be late.

Good day everyone, nice numbers to all of you.

Sébastien

Yesterday

 

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You have probably read this already but I had not. I found it very informative.

http://www.felinediabetes.com/FDMB/threads/newly-diagnosed-with-neuropathy.8003/#post-79718

Fingers (paws) crossed for negative test.

Thanks for the reading, will try to have a look at it if it's not as busy as it's been for a while
at the office.
.

 

[carfurby (GA)]

I hope SK comes down for you today and you can keep the ketones away.

 

[Osha]

 

[Kris & Teasel]

Good luck Sébastien!

 

[Carol & Murphy (GA)]

Crossing my fingers and Murphy is crossing his paws for SK

 

[Jill & Alex (GA)]

Thanks Jill for your rationality
in putting everything together. Even with this in mind, it's hard not to be concerned.

You're welcome.
You have every reason to be concerned. I don't want to minimize anything having to do with ketones. However, like everything in life, we must try to keep things in perspective. Continue testing for ketones daily. The red flag has been raised. It's imperative to stay on top of the possibility of more ketones developing.

Yesterday's black came out of nowhere, it cannot be just any hazard.

I think there's a strong possibility SK dropped into lower numbers yesterday (greens) and then bounced. It would certainly explain the black last night and the red this morning. Your new mission is to find out how low this dose is dropping SK.

 

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SK dropped into lower numbers yesterday (greens) and then bounced

Humm.... does make sens. You're just reminding me that I was suppose to reduce but wanted to kill
the bounce before . This dose is 7 days old, can bring green, but Small Kitty doesn't like these.

Problem on the table now is that ketone+SubQ are reducing insulin effectiveness...

Think I'll keep dose as is till Ketone falls down. Sadly I'm out of strips, will need to seek a
drugstore maintaining these.

Thanks again for you help Jill.
.

 

[Jill & Alex (GA)]

Humm.... does make sens. You're just reminding me that I was suppose to reduce but wanted to kill
the bounce before . This dose is 7 days old, can bring green, but Small Kitty doesn't like these.

Will SK self-feed if he feels his numbers dropping while you're at work? I can't remember, are you using a timed feeder for mid-day meals? I'm asking because reducing the dose now probably isn't the best idea.

One has to remember, the "ingredients" for developing ketoacidosis:
an insufficient supply of insulin (too low of a dose) + inappettance + infection or other systemic stresses

One wants to get as much insulin into the cat as is safely possible. If I were in your shoes, I would increase the amount of carbs fed at shot time and at +4 each cycle rather than lowering the dose. Maybe feed MC rather than LC in an effort to keep him from dropping too low instead of lowering the dose. Make sense?

Problem on the table now is that ketone+SubQ are reducing insulin effectiveness...

I respectfully disagree. Administering squids properly (away from the insulin injection site) should not reduce insulin effectiveness. Actually, in some cats, squids enhance the effectiveness of the insulin. Also, ketones themselves do not reduce the effectiveness of insulin. It's the reason behind the ketones... the reasons "why" kitty is throwing ketones that make the insulin appear ineffective.

IMHO, what you're seeing and calling "insulin ineffectiveness" is simply a bounce. Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Think I'll keep dose as is till Ketone falls down.

Good idea for the reasons I mentioned above. If you can "prop up" SK's mid-cycle numbers with MC, it may be a good idea to maintain the dose for a bit yet, again for the reasons mentioned above.

Sadly I'm out of strips, will need to seek a
drugstore maintaining these.

Yes, you want to try to keep an ample supply of strips on hand if at all possible.

Thanks again for you help Jill.

You're very welcome.
Have a good day!

 

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Will SK self-feed if he feels his numbers dropping while you're at work?

You're amazing Jill, love your scientific minding. Small Kitty is on feeder at +5. As soon as I see that yellow
is around I'll LC or NC (have new wet food that has nothing but vitamins and meat). I always see MC as
green/blue killer preventing healing time. With information you just shared, will switch momentum and
be less shy about MC in order to keep the dose as is.

Calling you a guru is really not an exaggeration.

*didn't follow all you advise with a late shot tonight, there is things that are out of your control some time.
Will push shot time by 45min tomorrow. Lucky Small Kitty was yellow.
.

 

[Jill & Alex (GA)]

Small Kitty is on feeder at +5. As soon as I see that yellow
is around I'll LC or NC (have new wet food that has nothing but vitamins and meat). I always see MC as
green/blue killer preventing healing time. With information you just shared, will switch momentum and
be less shy about MC in order to keep the dose as is.

Hmm, I understand your thinking, but you'll have to be very, very careful with choosing when you'll feed LC versus MC because kitties aren't known to share what their plans are in any given day.

If you plan on hanging onto this dose for the reasons we discussed, it would be safer for you to feed LC or NC at the beginning of a bounce and for the next couple cycles only and then use the MC. My reasoning is it appears he broke the bounce after only a few cycles this last time. You don't want LC or NC in that feeder when you're at work or sleeping when that bounce breaks.

Another reason to be very careful is the time it takes to clear a bounce is subject to change and we never know exactly when that will happen. What I'm trying to say is it's better to be safe than sorry.

Calling you a guru is really not an exaggeration.

No, there are no gurus or experts here. All we are is laypersons with different levels of experience and understanding who are trying to help each other out.